{
  "abstract": "An 8-month-old boy presented with a 5-day history of a rapidly progressing necrotic lesion on the right frontoparietal forehead extending onto the scalp. The lesion began as a small erythematous papule rapidly evolving into a necrotic ulcer with central eschar formation. The infant had no significant medical history and was otherwise healthy. Examination revealed a 4×5 cm necrotic ulcer with a dark central eschar surrounded by erythema and induration (figure 1). He was febrile (38.5°C) and exhibited regional lymphadenopathy. Blood tests revealed leucocytosis, elevated C-reactive protein and erythrocyte sedimentation rate with normal immunoglobulin levels, and HIV testing was negative. Cranial ultrasound was reassuring regarding intracranial involvement. Initial empirical antibiotics (ceftriaxone and amikacin) were started after admission to the paediatric ward. Cultures from the blood and lesion grew Pseudomonas aeruginosa sensitive to piperacillin-tazobactam and ceftazidime, prompting escalation of therapy followed by eschar debridement and daily wound care. The baby improved within 72 hours, and the ulcer began healing with granulation tissue. After 14 days of antibiotics, the lesion healed completely with residual scarring.",
  "authors": [
    {
      "affiliations": [
        "Department of Dermatology and Venereology, Maulana Azad Medical College, New Delhi, Delhi, India"
      ],
      "name": "Vishal Gaurav"
    },
    {
      "affiliations": [
        "Department of Dermatology and Venereology, Maulana Azad Medical College, New Delhi, Delhi, India"
      ],
      "name": "Pavani Gowda"
    },
    {
      "affiliations": [
        "Department of Dermatology and Venereology, Maulana Azad Medical College, New Delhi, Delhi, India"
      ],
      "name": "Anuja Rao"
    },
    {
      "affiliations": [
        "Department of Dermatology and Venereology, Maulana Azad Medical College, New Delhi, Delhi, India"
      ],
      "name": "Deepika Yadav"
    }
  ],
  "title": "Ecthyma gangrenosum in a healthy infant: a diagnostic challenge",
  "uid": "2f625a64-9566-59d7-bd04-41d82870b67e"
}